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Low risk of HBV reactivation in a large European cohort of HCV/HBV coinfected patients treated with DAA

2020; Taylor & Francis; Volume: 18; Issue: 10 Linguagem: Inglês

10.1080/14787210.2020.1782189

1744-8336

Jerzy Jaroszewicz, Małgorzata Pawlowska, Krzysztof Simon, Dorota Zarębska‐Michaluk, Beata Lorenc, Jakub Klapaczyński, Magdalena Tudrujek‐Zdunek, Marek Sitko, Włodzimierz Mazur, Ewa Janczewska, Katarzyna Paluch, Dorota Dybowska, Iwona Buczyńska, Agnieszka Czauż‐Andrzejuk, Hanna Berak, Rafał Krygier, Maciej Piasecki, Beata Dobracka, Jolanta Citko, Anna Piekarska, Łukasz Socha, Zbigniew Deroń, Olga Tronina, Łukasz Laurans, Jolanta Białkowska, Krzysztof Tomasiewicz, Waldemar Halota, Robert Flisiak,

Liver Disease Diagnosis and Treatment

The aim of the study was to analyze the prevalence and clinical characteristics of HCV/HBV coinfection and to evaluate the rate of HBV-reactivation during anti-HCV therapy in a large real-world study.Analyzed population consisted of 10,152 chronic hepatitis C patients treated with DAA between 2015 and 2019 in a nationwide study. Prior to the DAA all subjects had HBsAg and 60% anti-HBc testing.111 of 10,152 patients (1.1%) had detectable HBsAg and 1239 of 6139 (20.2%) anti-HBcAb. The prevalence of occult hepatitis B was 0.48%. HCV/HBV patients were younger with a higher proportion of males, HIV-coinfected, and advanced fibrosis. They were less often diagnosed with diabetes but more often with chronic kidney disease. In HBsAg(+) subjects with baseline HBV-DNA available 6/102 (5.9%) HBV-reactivations during or after DAA therapy were observed, and in two (1.9%) significant hepatic flares were noted. In HBsAg(-)/anti-HBc(+) group 2 (0.16%) reactivations were observed only in patients undergoing immunosuppressive therapy.Data from a large European cohort suggest a relatively low risk of HBV-reactivation during DAA-therapy for HCV infection in HBsAg(+) patients. In HBsAg(-)/anti-HBc(+) HBV-reactivation seems to be limited to subjects with immunodeficiency. Importantly, previous exposure to HBV and occult hepatitis B is present in a significant proportion of HCV-infected.